Month: October 2017

The end of 2018 is fast approaching, and we’re already seeing people full of excitement about their upcoming snow holidays for the end of the year and into 2019.

Each and every year we get panicked phone calls from people with injuries that have niggled on for months, who are off on their snow holidays in the next few days. We do our best to help however we can, but the human body needs time and investment to perform at it’s best, so we can’t work miracles overnight!

Skiing and snow boarding are very physically demanding. These holidays involve an intense period of activity. They are also precious time away with friends and family and don’t come cheap! So, you need to make sure your body can cope with the demands so you can really make the most of your holiday!

Our top tips

Get any ongoing or niggling injuries sorted now. Don’t wait until the week before you go away. There can be very simple and effective ways of resolving injuries once you know what’s going on and have a personalised recovery plan. The ‘wait and see’ approach can sometimes pay off, but if you have a physical challenge coming up, ask yourself is it worth risking it?

Do some specific strength and conditioning work to make sure you’re fit for the slopes. If you want a customised, specific programme, think about our small group rehab sessions with our Sports Therapy team. We have specific skiing and snowboarding sessions, led by Snowsport Physio Chris.

What is Osteoarthritis?

Osteoarthritis is a condition that affects your joints, causing pain and stiffness. It’s by far the most common form of joint disease, affecting people all over the world and at least 8 million people in the UK.

What causes Osteoarthritis?

Almost anyone can get osteoarthritis but certain factors can increase your risk, for example if you’re in your late 40’s or older, you’re overweight or you’re female (for most joints, especially the knees and hands, osteoarthritis is more common and more severe in women).

What might Osteoarthritis feel like?

The main symptoms of osteoarthritis are:

Pain – The pain tends to be worse when you move your joint or at the end of the day. If you have severe osteoarthritis, you may feel pain more often.

Stiffness – Your joints may feel stiff after rest, but this usually wears off as you get moving.

A grating or grinding sensation (crepitus) – Your joint may creak or crunch as you move.

Swelling – The swelling may be hard (caused by osteophytes) or soft (caused by synovial thickening and extra fluid), and the muscles around your joint may look thin or wasted.

Not being able to use your joint normally – Your joint may not move as freely or as far as normal. Sometimes it may give way because your muscles have weakened or your joint has become less stable. Exercises to strengthen your muscles can help to prevent this.

Your symptoms will often vary for no clear reason. Some people find that changes in the weather make the pain worse, especially damp weather along with falling atmospheric pressure. Others find the pain varies depending on how active they’ve been. In more severe cases, the pain might not go away. It might stop you sleeping and cause difficulties in your daily activities.

There are some great resources on the Arthritis UK website, where these images are from.

How do the symptoms of Osteoarthritis progress?

Symptoms of OA can vary. That may start severe but settle down or pain and stiffness can progress and worsen. What you do and how you manage your OA can really impact on the progression of symptoms. Keeping active and taking part in regular exercise is one of the best ways of helping your OA.

Possible complications of osteoarthritis include an increased risk of developing gout and chondrocalcinosis.

Gout is a common type of inflammatory arthritis, which is caused by high levels of urate that lead to sodium urate crystals forming in and around your joints. The changes that osteoarthritis causes in cartilage can encourage crystals to form within your joint. If you have both osteoarthritis and a high level of urate in your blood, you’re at an increased risk of developing gout.

Chondrocalcinosis or calcification is the formation of calcium pyrophosphate crystals in your cartilage. It can happen in any joint, with or without osteoarthritis, but it’s most likely to occur in a knee already affected by osteoarthritis, especially in older people.

How is Osteoarthritis diagnosed?

Osteoarthritis is usually diagnosed based on your symptoms and the physical signs that your doctor finds when examining your joints. this can include:

joint tenderness

creaking or grating (crepitus) sounds

bony swelling

excess fluid

reduced movement

joint instability

muscle thinning

X-rays are the most useful test to confirm osteoarthritis, although you probably won’t need one. They can’t really show how much pain or disability osteoarthritis is likely to cause. Some people have a lot of pain from fairly minor joint damage, while others have little pain from more severe damage.

Rarely, an MRI scan of your knee can be helpful. This will show the soft tissues (cartilage, tendons, muscles) and changes in your bone that can’t be seen on a standard x-ray

What is the best treatment for Osteoarthritis

Besides painkillers, steroid injections or surgery (when causing severe pain or mobility problems), the best treatment, according to the National Institute for Health and Care Excellence (NICE), is exercise.

NICE recommendations include:

advising patients to participate in exercise as a ‘core treatment’

offering weight loss interventions for patients who are obese or overweight

providing patients with holistic assessments

Exercise can help to manage some of the symptoms of arthritis. As Physiotherapists we provide advice and education on exercise, pain relief and ways to manage your condition. We can teach you how to improve your joint movement and your walking, as well as how to strengthen your muscles.

When you see us at goPhysio, we will assess your problem and give you tailored advice and a treatment programme. This may include some hands on treatments, an exercise programme and modifications to your lifestyle.

Prognosis for Osteoarthritis

It’s impossible to predict how osteoarthritis will develop for any one person. It can sometimes develop over just a year or two and cause a lot of damage to your joint, which may then cause some deformity or disability. But more often osteoarthritis is a slow process that develops over many years and results in fairly small changes in just part of your joint. This doesn’t mean it won’t be painful, but it’s less likely to cause severe deformity or disability. Sometimes the condition reaches a peak a few years after the symptoms start and then remains the same, or it may even improve.

The annual Back Care Awareness Week, run by BackCare, the UK’s leading charity for those impacted by back or neck pain, is to take place between 2 and 6 October. The theme this year is Back Pain in Education.

Back pain is one of the top common causes of absence from work throughout the country. It costs the UK economy around £15 billion every year as over four million working days are lost as a result of the condition. Furthermore, about 80% of the UK population will suffer from back pain at some point in their lives.

BackCare decided it was important to run a campaign targeted at children and young people as many of the back and neck pain problems experienced by adults are due to them not looking after their backs during childhood and teenage years.

The image here, that BackPain have promoted has the message ‘Don’t pick up heavy things’. There’s nothing wrong with picking up something heavy! In all our years as Physiotherapists, I don’t recall we’ve ever seen a young patient who’s injured their back by picking up something too heavy!

Dr Brian Hammond, the Chair of BackCare said: “Early teaching of children and young people of the importance of taking care of their backs is bound to have a positive effect on the health of their backs as adults.”

He added: “There are simple things children and young people can do, such as sitting properly and not for too long, exercising regularly, stretching and lifting correctly. They also need to know how to carry their school books and equipment in a way that does not harm their back or neck.”

Why we somewhat disagree with this years message!

However, leading Physiotherapists and the latest research will tend to disagree with some of the points raised in this campaign. Although we agree that education and empowering people with understanding and knowledge of taking care of their bodies from a young age is crucial, implying that they can damage their spines by doing normal, everyday tasks like carrying a school bag, is a myth. These messages can lead to an unnecessary fear, which can then progress into adulthood.

Research is suggesting that there isn’t a ‘perfect posture’ or ‘best way to carry a bag’. So implying that young children can ‘harm’ their back or neck in these ways isn’t a positive message to put across.

This image sums up perfectly how children should be caring for their backs – not focusing on correct postures or harmful habits – moving regularly!

So what messages should we be sharing?

Exercise and movement is the key – youngsters should be encouraged and supported to take part in a wide variety of exercise, sport and activities that encourage regular, whole body movement that they enjoy! It doesn’t really matter what it is, but enjoyment and instilling a lifelong, love of being active is the best way to prevent developing any back problems.

Move regularly – our bodies aren’t designed to be still. It’s not the posture that’s the problem, but staying in single positions for too long that can lead to issues. So, when you read about issues such as ‘text neck’, it tends to be the duration that people are using their devices in, in a single, sustained position that can cause issues. If you held a so called ‘perfect posture’ for any sustained length of time, this could cause issues!

Don’t be afraid of pain – aches and pains can be a normal everyday occurrence. We can all feel a bit of stiffness, aching, muscle soreness etc. But pain doesn’t always equal damage. Particularly with back pain, being afraid of the pain tends to lead to us being overly protective, not moving as much, which in turn can cause more pain. It’s a vicious circle. As long as there are no indications to be concerned that something more serious is going on to cause the pain (trauma, pins & needles or numbness, problems going to the toilet, pain at night for example – if any of these are present, it’s advised to see your GP ASAP), then we need to install the confidence that the pain is OK.

Be careful with the language we use – particularly with children, the words we use if they’re in pain can be very influential. Negative words like harm, damage, out of place, torn, can all create very negative messages. We need to focus on positive messages like strong and active. Being overly focused on carrying things correctly at a young age, will install a fear that their backs aren’t designed to cope with such a normal, everyday, task – which ins’t true.

There are obviously times and instances when children do develop back or neck pain. This can be caused by sustained postures (often technology related) and a lack of exercise of general movement. In these cases, specific education and increasing their awareness is a key part of helping them overcome any pain they are experiencing. Postural education may be a part of this.

It’s great that BackCare are are raising awareness of back issues in this campaign, but let’s keep the messages positive and not install a fear into young people that their backs might not be fit for the job!

Older People’s Day takes place on 1st October and this year celebrates the achievements and contributions that older people make to our society and the economy.

With age comes wisdom and life experience that is invaluable when passed on to younger generations. From looking after the grandchildren to volunteering at a local church group or running a community art class, life rarely slows down after retirement nowadays!

People are living longer than ever before with average life expectancy in the UK rising to 79.4 years, but how can we make sure we stay active and continue to enjoy good quality of life into our golden years?

If you don’t use it you lose it!

By keeping active we maintain muscle strength and joint flexibility, as well as keeping blood pressure and cholesterol under control to reduce the risk of stroke, diabetes and heart disease. Exercise can also help with weight loss and improve mood and mental wellbeing too…bonus!

Am I too old to exercise?

No! Its never too late.. check out these inspiring examples…………..

Tao Porchon-Lynch, the world’s oldest yoga teacher has just turned 98 and Fauja Singh; the 104 year old marathon runner who only took up running in his 80’s!

Where do I start?

If you haven’t exercised for years, start slowly – older joints will have a tendency to be stiffer, particularly in the mornings and in cold weather.

A physiotherapist can help by assessing your muscle strength, flexibility and balance and create a tailored individual exercise programme to address these as well as treating any aches and pains you may have.

A gentle stretching routine every morning might be all that’s needed to keep you supple enough to chase after those grandchildren!

Falls prevention classes/Chair based exercise classes – why not try our specialist Positive Steps classes. Held twice a week they are specifically designed to help maintain and improve strength, balance, flexibility and fitness for those 60+, in a friendly, social and caring environment.

Dancing – did you know dancing has been shown to reverse signs of aging in the brain and improve mental and physical wellbeing in an older population, it’s even being used to help treat Parkinson’s disease!

How long do I need to keep it up for?

The key is to find something you enjoy, that makes you feel good so that it doesn’t feel like hard work to keep it up indefinitely. Whether that’s a Pilates class, dancing or gardening the most important thing is that you’re getting out there and getting moving!

It often doesn’t take any fancy equipment and there are no requirements for lycra or leotards but all you need is a healthy disregard for the stereotype of age and a little bit of motivation to stay youthful!

Here are some very simple exercises you can do to help maintain strength and balance.